Introduction

Occurrence of pancytopenia in patients with untreated hyperthyroidism is extremely rare. To the best of our knowledge, only 30 cases have been reported in the English literature. Accurate diagnosis and appropriate tailored therapy are challenging due to the variegated causes of pancytopenia and the potential hematological toxicity of antithyroid drugs (ATDs).

Case report

We present a 51-year-old Caucasian man with newly diagnosed Graves’ disease showing pancytopenia and liver dysfunction. Although in this context the use of ATDs is still under debate, low-dose methimazole therapy was able to induce resolution of both pancytopenia and liver dysfunction, along with euthyroidism restoration.

Conclusion

Searching in the English literature for previous studies, we identified only 30 cases worldwide to form our database. A demographic as well as clinical, laboratory, and histopathological analysis was performed. In most cases, the recovery of biochemical euthyroidism through the use of ATDs induced the resolution of pancytopenia (at laboratory and histological levels). Our review provides clinical, laboratory, and histopathological features of Graves’s hyperthyroidism-related pancytopenia with a view to improving the knowledge of this rare hematological complication and assisting in the decision-making process regarding therapeutic options.

中文翻译：

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Graves 甲状腺功能亢进相关的全血细胞减少症：一例文献复习的病例报告。

介绍

未经治疗的甲亢患者发生全血细胞减少症极为罕见。据我们所知，英文文献中只报道了 30 例。由于全血细胞减少症的多种原因和抗甲状腺药物 (ATD) 的潜在血液学毒性，准确的诊断和适当的定制治疗具有挑战性。

案例报告

我们介绍了一名 51 岁的白人男性，新诊断的格雷夫斯病显示全血细胞减少和肝功能障碍。尽管在这种情况下，ATD 的使用仍存在争议，但低剂量甲巯咪唑治疗能够诱导全血细胞减少症和肝功能障碍的消退，同时恢复甲状腺功能正常。

结论

在之前研究的英文文献中搜索，我们仅在全球范围内确定了 30 个案例来形成我们的数据库。进行了人口统计学以及临床、实验室和组织病理学分析。在大多数情况下，通过使用 ATD 恢复生化正常甲状腺功能可诱导全血细胞减少症（在实验室和组织学水平）的解决。我们的综述提供了 Graves 甲状腺功能亢进相关的全血细胞减少症的临床、实验室和组织病理学特征，以期提高对这种罕见血液并发症的认识，并协助有关治疗选择的决策过程。